Grief, guilt, depression: a self-help journey ~

On a sad and foolish day in mid-May during which I got emotionally needy and expressed myself histrionically to a sometime-reader of this blog, he accused me of being unwilling to “take a single step” to help myself with my depression and social isolation. This criticism infuriated me not least because it was grossly untrue.

Nonetheless, his assertion got me to thinking about the whole question of self-help, and I found myself still thinking about it several weeks later. I realized I was beginning to forget some of the things I’ve done in the past eight years, since I left my husband and found my own life spiraling out of control after he died. As a way to preserve this piece of my self-history for myself and for any future counselors I have—and, I hope, to help others—I decided to list and discuss the things I’ve tried to reduce my guilt and grief over my ex-husband’s death and to alleviate the severe depression and social isolation that resulted. What helped? What didn’t? What did I not try, and why didn’t I try those things? Why did I abandon some of the things I tried?

This is an extremely long post, something of a primer on depression, isolation, and loneliness, and it’s not intended for casual readers. Rather, it’s meant in part to give some perspective and advice to fellow sufferers and those who love them. Therefore it comes with the standard disclaimers: I’m not a doctor or therapist; these are strictly my own impressions based on my own experiences; consult a professional if you suffer from depression; get help if you’re feeling suicidal. Okay? Please act in your own best interest. Variability also comes into play. Tolstoy wrote “[E]very unhappy family is unhappy in its own way.” Every depressed person, I think, is depressed in her own way. The fact that my depression has been inextricably bound up with guilt, grief, and loneliness does not mean that your depression is as well. Consequently, what this post has to say will not be of use to everyone (and maybe to no one).

I’m not taking into account here the year and a half I hung onto my job after my ex-husband’s death, or the many ways I tried to help him before he died. I’ve written about that elsewhere in this blog (“Into the Confessional“). Nor am I taking into account the endless repairs I had to coordinate for the house I bought for myself and my disabled sister, or the many ways I’ve helped her, or the work involved in selling that house after she bought her own, or my own house search and second move, or the fact that I supported an on-again/off-again boyfriend in 2014, the fourth and final year of a turbulent relationship. All those things fall under the headings of work and trauma. What I want to do here is recall the things I did to try to keep my head above water. Although most of them didn’t help me, I believe each of them could be valuable for others.

That leads me to another caveat: My depression was severe enough to keep me mostly in bed for several years, which means I have little stamina or strength. That in turn made it harder for me to help myself. This probably is not a typical situation for most people. In addition, I found out about a year ago that I have severe anemia, which is contributing to my exhaustion. It’s possible I’ve been anemic for years; there’s no way of knowing. For two or three years before I left my husband—we’re talking at least 10 years ago now—I experienced increasing trouble getting going in the morning. I’d also begun having occasional days—most often Saturdays, at the end of the work week—when I was so tired I stayed in bed all day. I attributed this development to overexercise and the (very slow) approach of menopause. It may in fact have been due to iron deficiency. My fatigue was exacerbated by depression. Without the disabling fatigue, I might have been able to keep my job, or to find fulfilling volunteer work, or to more easily take steps to counter the deconditioning I experienced from being in bed.

Anyway, let’s start with the standard therapeutic stuff.

  • I attended Al-Anon meetings before my ex-husband’s death. This lasted two or three months, until I could see that Al-Anon’s philosophy had nothing to offer me. As part of this effort, I also called people from Al-Anon who volunteered conversation and advice. I should note that Al-Anon has helped many people; I just happened not to be one of them.
  • Because my husband had attempted suicide and because I myself felt suicidal, I tried a suicide support group. Again, for various reasons this wasn’t a helpful group for me.
  • I also tried a grief support group at my town’s Center for Independent Living. I gave up on this very quickly, because the participants spent most of the sessions talking about their efforts to gain financial stability. This was extremely important for them, so I’m not denigrating it, but it wasn’t my issue or the purpose of the group. If another grief support group had been available, it would have been a better bet.
  • I tried new medications. Eventually my psychiatrist put me on a second antidepressant. I also tried an adjunct therapy, Abilify, which substantially relieved my depression…for about six weeks. Although it made me feel spacey, it worked beautifully during that short period of time. Unfortunately, it coincided with:
  • My participation in what’s called an outpatient partial-hospitalization program. This particular program involved three full mornings of group therapy per week for four weeks. Thanks to the Abilify, I was temporarily (and deceptively) doing very well. The program itself, however, was unimpressive; I thought it was much too superficial to help someone with severe depression or suicidal thoughts. Similar programs offered in different parts of the country might be much more effective.
  • I underwent a voluntary two-week hospitalization in November 2009 for six sessions of electroconvulsive therapy. The idea of ECT terrified me, and it took two years of desperation for me to work up enough courage to try it. I re-entered the psychiatric ward—again, voluntarily—the following month for three more treatments. ECT seemed to help a little, but not dramatically, and the effects quickly wore off. (NOTE: It remains the case that ECT is the most effective treatment for depression; it helps about 70 percent of people.) In July 2014 I checked myself into a psychiatric hospital in St. Louis, ready to do another round of ECT, but for reasons I won’t get into, I immediately negotiated an early release predicated on my agreement to undergo at least one ECT treatment. Unlike my previous treatments, this one had bothersome side effects. More worrisome to me was that it was not conducted by the psychiatrist I initially spoke to, and was not done according to the protocol we agreed upon. Given that troubling circumstance, I insisted on the early release. My sister later was in this hospital for almost a month; ECT helped her, but the shortcomings of the hospital countered her improvement.
  • These stays, incidentally, opened my eyes about psychiatric wards. Much of what I assumed went on in such places does not in fact go on. For example, I assumed I’d be meeting with a therapist or psychiatrist daily. Not so; I met with one, once. I assumed that group therapy would take up much of the day and would be extremely intensive. Not so; there was a singularly nonintensive session each morning. There were no facilities for exercise, which is something proven to help many people with depression (not me, unfortunately, but many). I never imagined that time on the ward would be spent instead in kindergarten-level crafts sessions. I’ve spoken to various doctors about my experience, and I’ve observed my sister’s experience on two psychiatric wards. Unless you’re unfortunate enough to be committed to a state institution, or fortunate enough to be able to afford a long-term stay in a private hospital, the goal of hospitalization is to stabilize you and get you out of there. (Those last few words are quoted verbatim from a psychiatrist.) It’s unusual for most places to keep you more than two weeks, which simply is not long enough to assess the effects of various medications on your depression. If you’re psychotic or suicidal, hospitalization certainly has a place, and it also has a place if you can’t get ECT as an outpatient.
  • I did quite a bit of online research on other treatments for depression, but these were still pretty experimental, expensive, and not covered by insurance. One of them, transcranial magnetic stimulation, does basically what ECT does (disrupts certain neuronal pathways), but less effectively. My research accords with what my psychiatrist asserts: TMS hasn’t lived up to its early billing. The other treatment, vagus nerve stimulation, involves surgery and still doesn’t have a long or especially notable track record.
  • For a year and a half, I saw a grief counselor, a former faculty member who specialized in death education, among other things. Once a week after work I went to her house and talked with her for one to two hours. She did this for free, an amazingly generous effort. Although the work we did and the exercises she suggested didn’t help me, she is now one of my best friends—and as a friend she has helped me considerably. Friends help. Let me qualify that: Friends with some understanding of what you’re going through help.
  • I also was seeing a conventional therapist during most of the years since my ex-husband’s death. When the first one hadn’t helped after a year or so, I switched to another one for several months. I later switched back to the first one. Perhaps I should note that in my adult life I’ve seen 14 or 15 therapists—men and women, young and old, with differing qualifications and differing approaches. Some of them I saw only two or three times. Some of them I saw for years. None of them helped me resolve any of my problems. YMMV. There was a key benefit, though: the ability to blow off steam and to direct toward the therapists some of the despair with which I would otherwise have burdened my friends.
  • Did I mention that I called friends? During the worst of the depression I would be seized every afternoon or evening with an absolutely panicky need to call somebody. I tried to cycle these calls among my friends so that no one person would be overburdened, especially since much of my talking was mixed with crying and I was hard to understand. Inevitably I lost friends, though, and it’s hard to replace friends when you’re not working.

These therapy-based efforts didn’t pay off for me, but they can help others and they’re all worth considering. What helped me more were other things I tried.

  • I took singing lessons for three years. There were days that I was too fatigued or depressed to get out of bed, but I hung in there. The singing lessons were good for me because I enjoyed them and they involved personal interaction.
  • I volunteered for one semester at WSIU’s Reading for the Blind program (SIRIS), until it became clear that my voice couldn’t handle both this and the singing lessons. I chose to give up SIRIS because they had plenty of volunteers (there was actually a waiting list) and because it was a totally isolated activity (you’re in a room by yourself, reading into a microphone). I would like to do more volunteer work, but I haven’t yet. Why not? Without the structure of a job, my sleep schedule has turned nearly upside-down. In addition, my depression and my debilitation combine to make me an unreliable volunteer who must rule out many activities because of physical limitations. For the same reason I haven’t sought out a part-time job.
  • I did, however, jury into the Visual Artists Cooperative in Cape Girardeau (I do fine-art photography), where I was a member for about two years. This involved displaying a new piece every month and participating in exhibit change-out days. When I became too debilitated to drive round-trip to Cape and also pull my weight on the change-out days, I felt I should resign, so I did.
  • I set up, but never publicized, a freelance copyediting business. Why did I not go through with it? Just after I’d finished the website, but before I’d done flyers or ads or business cards, a faculty acquaintance asked me to edit some things for him. I did a job application letter for him, then his CV, then his website. Working was good for me, but at each juncture I found that I simply couldn’t charge him any money. I set aside the idea for the time being, although I may return to it.
  • I took my on-again/off-again boyfriend on a trip to the Rocky Mountains, which he had never seen. It was great to travel. The flip side was that it was also demoralizing to see how much trouble I had walking, when the altitude had never bothered me before. I knew I needed to get back into shape. So:
  • I met three times with a personal trainer, until it became clear that he was not equipped to help someone as debilitated as I already was. Next:
  • I tried physical therapy three times a week in 2013. These sessions exhausted me, sometimes putting me in bed for days. After about three months I had to quit. However:
  • I tried again for several months in 2014, this time doing two sessions a week. They still exhausted me. In retrospect I realize that I was severely anemic during both PT attempts, which undercut my efforts.
  • I took a silversmithing class at the local community college. I made it through about two-thirds of the class; unfortunately, the work flared up my longstanding tendinitis, so I had to give it up. I do, however, now have a much greater appreciation of the work done by jewelry makers and the costs of their materials. It was fun while it lasted, even though I accidentally set my towel on fire once. I’d already taken most of the other community college courses that interested me, although I check the listings each semester. If I can regain stamina, I plan to apply for a community listener’s permit so that I can sit in on some courses at the local university. Right now I’m too debilitated to walk very far from the parking lots to the buildings. That sounds pathetic, but it is what it is.
  • I took two solo road trips: one to Memphis and New Orleans, and one to Clarksdale, MS. These confirmed my ability to travel alone without any qualms, and I enjoyed what I did. However, I severely overextended myself in Memphis and arrived in New Orleans so fatigued that I could barely drag myself around the aquarium and to Café du Monde. Clarksdale was a more manageable trip. My fatigue level is now too high to make a trip of five or six hours comfortable; I could no longer drive from Memphis to New Orleans in one day. But if you’re physically able, I highly recommend solo road trips for reaffirming self-confidence. If you’re single and lonely, they can make you more acutely aware of your loneliness. But they’re worth it. Traveling with a companion also is a good idea. You need a change of scene.
  • Depression tends to be socially isolating even for people with extended family or strong friendship networks. It can be much worse for single people, childless people, and retired people whose friends are busy with work and family. If you’re forced as I was to retire quite young because of depression, you quickly find that work constituted much of your identity and provided much of your social interaction. I use Facebook to keep in touch with friends and acquaintances. A few months ago I made a special post there explaining that I was looking for activity companions; this yielded very little. I’ve also reached out privately to a few acquaintances, both men and women, to see if they had time to do things together, but that also yielded very little. That brings us to online dating sites. When I felt ready—though I probably was not ready—I signed up for OkCupid. I’ve also subscribed to eHarmony twice; Match.com three times; OurTime once. I have met guys on these sites whom I’ve dated or just been friends with. This is a double-edged sword: Dating decreased social isolation but increased heartache. Rejection on these sites can eat at your self-esteem (which is already low if you’re depressed) and can make you feel even more lonely. Rejection is the rule for me now that I’ve gained weight, but dating sites are still the most viable place for me to meet potential partners. For people who have extended family or lots of friends where they live, or who are churchgoers, perhaps, this may not be true.
  • Finally, when I’ve been able, I’ve gone by myself to movies, plays, and lectures. That too is a double-edged sword for single people: You have the activity to enjoy, but it can be depressing to see almost everyone paired up. Go anyway if you can.
  • Oh, and I started this blog. It’s been intermittent, but I write when I have something to say, and I try to get out when I can to take photographs.

One of the reasons severe depression is so pernicious is that it renders a person so helpless. It’s tremendously hard even to get out of bed. Simply taking a shower can be a major achievement. Getting your groceries and pushing through the aisles of a Wal-Mart Supercenter are arduous exercises. If you live alone, you must be your own caregiver. People who haven’t experienced severe depression will be impatient with you and may, despite their good intentions, say hurtful things. You will probably lose friends; most people with severe depression do.

Given these realities, I feel pretty good about the number of things I tried, even though my results were lousy and I think I should have done better. But readers may find that things which didn’t work for me will work for them. So much depends on circumstances. For example, I suspect there’s a great variation in the effectiveness of grief support groups. For what it’s worth, I believe the best things are getting out of the house whenever you can make yourself do it, getting back to nature (I took frequent drives to a nearby wildlife refuge, and still do), engaging in creative activities, working part-time or volunteering if you’re able, and getting the hell out of town whenever you can—with a companion, if you can.

As for me, right now I’m undergoing iron infusions that I hope will give me enough energy to start an exercise program. If I can regain some stamina, more opportunities will open up for me to take some of my own advice.

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Please stand by ~

To Higher-Ups:

The Technical Team has noted serious technical difficulties with Blog entitled “Vapor and Flow,” with no forward (or backward) movement observed since mid-January. Blog is currently parked in the Driver’s front yard, where it seems to be accumulating trash. Driver has not yet had it put up on blocks, but Technical Team is on alert.

Team suspects a problem with the fuel injection system, though without hands-on investigation it is impossible to tell whether the gasoline tank might simply be empty. Team had noted some juddering of the steering wheel, accompanied by slightly erratic driving, in December and early January, indicating the need for immediate tire rotation and rebalancing. In addition, tires should be checked for wear. Driver has done none of this.

Driver herself, rather than repairing the Blog or addressing various ethical quandaries in her life at the moment, has become obsessed with the dog urine stains in her carpeting and the possibility of replacing the carpeting with something that can simply be hosed down. She daily repeats a monologue that always begins the same way (“I can’t stand this! What am I going to DO?”) and ends the same way (“But how would they move the piano?”). Technical Team estimates that said piano, a tall, ancient upright, weighs slightly more than a Volkswagen Beetle, flower holder included. Unlike a Beetle, the piano would probably not float, although Team finds this an intriguing question and would very much like to be notified of the results of any experiments along these lines. LOL.

Excuse us, that was unprofessional on our part. To continue, Driver also appears obsessed with a new personal best in Scrabble: her highest-ever non-bingo word score (GAZEBO, 84 points). While interesting numerically, this is judged by Team to be a rather trivial achievement in the grand scheme of things and recommends that Driver should just Get Over It.

Excuse us, please ignore editorial comment. Finally, Technical Team notes that on multiple occasions recently Driver has stated that she “dodged a bullet” because the voice student portion of a recent music recital was cancelled. This comment has been flagged for further analysis, but Team can only assume that someone slated to attend said recital was prepared to use firearms in the event of Driver singing. Team has insufficient information to gauge (pun! LOL) the appropriateness of the posited firearm use.

Excuse us again; Technical Team is fatigued and too easily amused. Team judges that Driver is currently earning A’s in Reading and Scrabble (quantity only), D’s in Physical Therapy and Caregiving, and F’s in Voice Lessons (lack of practice), Problem Resolution (dithering), Diet Remediation (inaction), Photography (inaction), and Blog Repair (inaction and negligence). Given this poor functioning, Driver’s hair looks better than might be expected, although Team is not well trained in assessing such matters.

In conclusion, Technical Team advises continued close monitoring of Blog and Driver, with future updates as necessary.

—Submitted February 23, 2014, ungodly hour of the morning
(Technical Team wishes to note that it has worked overtime on this report and would like to be duly compensated. Thank you.)

It takes a village ~

I don’t know about raising children, since I haven’t had any. My family was so insular, I don’t think I had a village growing up, unless you count my teachers and my pediatrician.

But I do know this: It takes a village to sustain a late-middle-aged, debilitated, single homeowner who’s clueless about fixing things. My village comprises a great many support people, by whom I mean people that I pay to help me keep my life in order.

All of us lucky enough to live above the poverty line have some people, of course. We have doctors and dentists. Some of us have shrinks and even more of us have therapists. Most of us have car mechanics and hairdressers or barbers.

Oh, for the simple life. The other day someone knocked on the door. It turned out to be My Realtor, bearing a beautiful large poinsettia. She sold my last house and helped me buy this one. Neither transaction was big enough to warrant the poinsettia, but I’m guessing realtors in this town are having a tough time as university enrollment keeps going down. I’d long ago decided that if I ever sell this house I plan to use her again. So, astonishingly, I have a realtor.

I also have a housekeeper. Probably hundreds of people around here have housekeepers, but most of them work or are over 70. I’m just weak. So when I have to refer to this person in conversation, you’d think I had a chicken bone stuck in my throat. How it comes up in conversation when I find myself in so few conversational situations is a mystery, yet it does. Often I find myself referring to T. as “the woman who cleans my house for a couple of hours every other week,” which is an awfully long ride on the merry-go-round. Yet to call her My Housekeeper sounds so…possessive. So elitist. So needy.

That’s not all. There’s also My Lawn Guy (who doubles as My Gutter-Cleaning Guy), My Tree Guy, My Garage Door Guy, My Handyman, My Electrician, and My Piano Tuner. The last three would have no idea that I consider them in this vein, since it’s been two or three years since I called any of them. But I intend to use them again, so there you go. I recently acquired My Carpet Cleaner (a man, not a machine) and My Snow-Shoveling Duo (a young man and woman much friendlier than the tough-looking guys in scruffy pickups who usually drive in from the country to shovel driveways after a snowfall).

Then there’s My Roofer. He has probably repressed the memory of me and my last house, which developed a series of bizarre leakage and mold problems that required patches, eventual re-roofing, a ridge vent, and a specially designed series of vents around the chimney. (I will write about this house someday when I’m sure I can hang on to my emotional equilibrium. I’ve referred to it elsewhere in this blog as the house that hated me.)

When I was working, I had My Massage Therapist (who was also my friend and a former co-worker). For well over a decade he kept me able to work despite painful tendinitis in my wrists and elbows. Eventually he talked me into acquiring My Rolfer, who also helped a great deal. But My Massage Therapist abandoned me to head the local community college’s massage therapy program, and after I quit work I could no longer afford My Rolfer. For three weeks last year I had My Personal Trainer, until I realized that he was going to kill me. Not on purpose, but still. It turned out that I was already too debilitated for My Personal Trainer’s lowest level of assistance. So far I’ve avoided needing My Caregiver, but I figure that’s next unless I can be my own personal trainer.

I have no need for an accountant, but I like My Lawyer, although I don’t like her law firm’s fees very much. Soon I may gain My Financial Consultant, whom I hope I won’t have to consult very often. Once would be enough, really. I can’t see the fabled one percent through a telescope from where I sit, but because I had to retire early and because my sister is disabled, I need to be fiscally prudent.

I even have people for after I die: My Funeral Home. Last summer I was getting things in order so that my death would cause my sister as little burden as possible. I’ve been terrified of death since I was a little girl, so when I decided to move on this, I did it fast. Within the space of an hour, I realized that I needed a “pre-needs” contract, called the funeral home, found that I could meet with them immediately to set up a contract, did just that, and returned. It may have been the fastest pre-needs transaction in the funeral director’s experience.

It was one of those days when I’m always on the verge of tears, and on such days I usually behave strangely. More strangely than usual, that is. I kept stressing that I needed a contract immediately. The assistant, a skinny, prematurely wrinkled woman with jet-black hair and several layers of makeup (practice?), summoned the funeral director, to whom I again stressed the urgency of the situation. They seemed surprised that someone so young wanted a contract. I knew I just wanted (pardon the language) a bare-bones agreement, no service, no urn. A fast reader, I blazed through the cremation contract, had them make a couple of changes, thrust a check at them, gave them my prewritten obit, and made sure my sister wouldn’t have to do anything.

As the assistant guided me through the labyrinth of rooms to the front door, the tears started in earnest. She asked if I was all right. For some reason I cannot train myself to simply answer this question with “Yes” or “I’m fine.” I seem to have a sort of hyper-honesty genetic mutation that results in some unfortunate, peculiar, or embarrassing answers. “I’m not well,” I said stiffly, and made a break for my car, undoubtedly leaving the woman convinced that I had a terminal illness and that they’d be firing up the furnace any day.

So I’m pretty well covered. I feel bad that I’m so incompetent and that my village is so big. On the other hand, it is pleasingly amiable and few of its members get called upon very often. I comfort myself with the thought that there’s an entire ritzy support tier that I’ll never have to have, nor could I afford. I don’t have a gardener (or a garden), a pool guy (or a pool), or a horse boarder (or a horse). I don’t have a chauffeur, an interior decorator, a party planner, a social secretary, or a chef (I need one). Although my friends may regret it when they see how I’m dressed, I don’t have, god forbid, a personal shopper.

And I don’t have, I’m happy to say, a ghostwriter. For better or worse, where this blog is concerned it’s just me on the loose taking a walk outside my village.

Bursting bubbles ~

It does seem to be true, at least in my case, that pride goeth before a fall, although one could predict that due to probability alone. For the past two days I’ve been congratulating myself on learning a new skill: giving subcutaneous injections. Last Friday a nurse came to my sister’s house to give her the first of five injections of an insanely expensive drug that may reduce inflammation, thereby increasing her mobility. (Heartfelt thanks to the Chronic Disease Fund, which paid the $2,000 for 5 milliliters of this medication.)

The remaining four injections would be my responsibility to do, so the nurse walked me through all the steps, which were more numerous than I’d anticipated. Warm the refrigerated vial between your palms for three minutes. Disinfect the rubber top of the vial with an alcohol wipe. Attach an 18-gauge needle to the syringe. (The smaller the number, the bigger the needle, I learned—just like camera apertures.)

Draw back the plunger to the 1 milliliter mark to fill the syringe with air. Twist the protective cap off of the needle. Push the syringe into the vial. Push the plunger to force out the air. Upend the vial and, making sure the tip of the needle is submerged within the liquid, draw back the plunger to the 1 mL mark. (Yes, this is a long and boring explanation, but it’s necessary to the point of the post. Pun intended.)

Then comes the tough part: checking for bubbles. Tiny bubbles are okay, but anything bigger should be dealt with by flicking your finger against the syringe repeatedly until the bubble slides toward the business end of the syringe. Push the plunger a bit to ease the bubble up through the needle. Draw the plunger back down to 1mL and repeat. This process turned out to be both tricky and tedious: there is an area at the end of the syringe where there’s some plastic threading, and it always looks empty, as if there’s a bubble there. Often, though, it’s just an optical illusion.

When you’re satisfied that no substantial bubbles remain, remove the needle from the vial. Put the protective cap back on the needle and twist it off the syringe. Replace it with a smaller gauge needle and take off its protective cap. (These seem to resist removal.) Make sure a tiny droplet of medicine shows at the end of the needle, supposedly indicating there’s no air in the syringe.

Then swab your victim’s thigh (in this case) with an alcohol wipe, pinch a goodly bit of her flesh between thumb and forefinger, and make the stick. The needle should go almost all the way in, but not quite. Turn loose of her flesh and pull the plunger back slightly to make sure no blood enters the syringe, which would indicate that you’ve hit a vein. If everything looks good, inject the liquid, remove the syringe, and slap on a bit of gauze.

Simple, right? The nurse allowed me to do everything except the one thing she could not, because of some financial rule or other, allow me to do: make the stick. Naturally, this was the part of the procedure that scared me the most. As I poised the needle above C.’s thigh on Saturday, I hoped fervently that I would not spear her and produce a bloody mess. I steeled myself to hear howling, and I made the stick. No sound from C. The needle might have gone all the way in, which was wrong, but it turned out beautifully.

I injected the medication, pulled out the needle, and marveled that at first I couldn’t even see where the injection had been. A dot of blood much smaller than a pinhead soon showed itself. No bigger than the nurse’s had been! I did an abbreviated victory dance while C. pressed gauze on the spot, and then a completely unnecessary Band-aid went on. Woohoo!

Things went equally well on Sunday—except that I remembered just after I gave C. the injection that I’d forgotten to pull back the plunger to check for blood. But chance saved me: there was again just a teensy dot showing where the needle had gone in. I was pretty good at this, hey? I could be a sub-Q shot giver, were there such a job. What competence!

Then today rolled around. I drew the medication into the syringe and there appeared to be no major bubbles. This seemed suspiciously lucky, so I flicked my finger against the syringe a few times and tried to determine if a bubble was lurking at the hard-to-see end. After some fiddling around with the plunger, I finally decided that there wasn’t. I switched needles. In the process of struggling to remove the thinner needle’s protective cap, however, I realized that I didn’t have 1mL in the syringe. I had closer to 0.9 mL. The nurse had specifically told me this was NOT okay.

Crap! What to do? With considerable misgivings I decided to switch the needles again and draw more medicine out of the vial. I was pretty sure the nurse would have told me not to do this, but I couldn’t think of an alternative. I also didn’t see how anything would be contaminated, since the first needle had gone back into its protective cap. After making certain I had 1mL, I checked for bubbles again. Flicked again. Switched the needles again and ascertained that a droplet of medicine clung to the tip.

I remembered this time, after making the stick, to check for blood. There wasn’t any. To my consternation, however, when I drew the plunger back slightly, a large, sinister-looking bubble appeared at the needle end and slowly made its way up the syringe.

OH CRAP. OH CRAP.

I had quizzed the nurse extensively about this entire bubble subject, because it worried me so much. “What if I miss a big bubble and inject it into her?” I asked. “Am I going to kill her?”

Undoubtedly the nurse was laughing on the inside, but she kept a straight face. “No,” she said, “but the shot will be more painful. It’s if you have an air bubble inside a vein. Now that’ll get you.”

Frozen in place with the needle in C.’s thigh, I reasoned that since there had been no blood, I could not have hit a vein. I warned C. that this shot might hurt—the others hadn’t—and I pushed down on the plunger. There was a bigger spot of blood this time when I removed the needle, but no spurting—in fact, no Carrie-type scene of any kind. C. hadn’t made a sound.

“Did that hurt?” I asked her anxiously.

“Not really,” she said.

“I don’t think I killed you,” I said with relief.

“Oh well,” she replied. I almost expected her to add, “Nobody’s perfect.”

One more injection to go. Then I should be done with wielding needles for awhile. Maybe forever, if I’m lucky. And if anybody asks me about the experience, I’ll say modestly, “I did reasonably well. We both lived.”

Addendum: After the final injection, I had to revise this post because I still had a step wrong. Perhaps this is why I never taught Technical Writing.